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目的 探讨神经影像导航辅助下显微外科切除颅底肿瘤的效果。方法 回顾性研究我院 2 0 0 0年 1月至 2 0 0 3年 8月收治的 44例颅底肿瘤 ,其中垂体瘤 8例 ,鞍结节脑膜瘤 12例 ,颅咽管瘤 9例 ,桥小脑角肿瘤 7例 ,蝶骨嵴脑膜瘤 5例 ,后颅窝海绵状血管瘤 3例 ,应用StealthStation影像导航系统 ,导航辅助显微外科切除肿瘤。结果 导航头皮注册平均误差为 ( 2 .7± 1.2 )mm ,颅骨钻孔标记注册误差 ( 1.5± 0 .8)mm。 44例病人达到肿瘤全切 3 8例 ,全切率 86.4% ,肿瘤次全切 4例 ,大部切除 2例。手术并发症包括动眼神经损伤 2例 ,面神经麻痹 2例 ,一过性尿崩 6例 ,无手术死亡。结论 神经影像导航辅助下的颅底肿瘤显微外科切除 ,定位准确 ,能提高肿瘤全切除率 ,减少并发症。
Objective To investigate the effect of microsurgical removal of skull base tumors assisted by neuroimaging. Methods Retrospective study of 44 cases of skull base tumors in our hospital from January 2000 to August 2003, including 8 cases of pituitary tumor, 12 cases of saddle nodular meningioma, 9 cases of craniopharyngioma, 7 cases of cerebellopontine angle tumor, 5 cases of sphenoid ridge meningioma and 3 cases of posterior fossa cavernous hemangioma. StealthStation imaging and navigation system was used to navigate tumor assisted microsurgery. Results The average scalp registration error was (2.72 ± 1.2) mm, and the registration error of skull drilling marks was (1.5 ± 0.8) mm. Forty-eight patients achieved complete tumor resection in 38 cases, total resection rate 86.4%, total subtotal tumor in 4 cases and partial resection in 2 cases. Surgical complications included 2 cases of oculomotor nerve injury, 2 cases of facial paralysis, 6 cases of transient diastole, and no operative death. Conclusions Neuroimaging assisted by microsurgical removal of skull base tumors with accurate positioning can improve the total resection rate and reduce the complications.